Gamma/Delta Phenotype in Primary Cutaneous T-cell Lymphomas and Lymphoid Proliferations : Challenges for Diagnosis and Classification - 20/05/21

Doi : 10.1016/j.path.2021.03.001

Carlos A. Torres-Cabala, MD ^a,^b,^⁎ , Auris Huen, MD, PharmD ^b, Swaminathan P. Iyer, MD ^c, Roberto N. Miranda, MD ^d
^a Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 85, Houston, TX 77030, USA
^b Department of Dermatology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1452, Houston, TX 77030, USA
^c Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 429, Houston, TX 77030, USA
^d Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 72, Houston, TX 77030, USA

^∗Corresponding author.

Abstract

Primary cutaneous T-cell lymphomas pose a diagnostic challenge for dermatopathologists, hematopathologists, and general surgical pathologists. Recognition of gamma/delta phenotype in cutaneous T proliferations has been enhanced by the availability of antibodies against TCRgamma and delta for immunohistochemistry. Thus, reporting gamma/delta phenotype in a cutaneous T-cell lymphoid proliferation may indicate a significant change in therapy and a challenge for dermatologists and oncologists who treat these patients. Herein, we discuss primary cutaneous gamma/delta T-cell lymphoma, its differential diagnosis, and other skin lymphoid proliferations that may show gamma/delta phenotype. Awareness of the occurrence of gamma/delta phenotype in both T-cell lymphomas and benign lymphoid proliferations involving skin is crucial for a better interpretation of histopathologic findings. Integration of clinical presentation, morphology, immunoprofile, and molecular findings is key for a correct diagnosis and appropriate therapy of lesions displaying gamma/delta T-cell phenotype.

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Keywords : Gamma-delta T-cell lymphoid proliferations of the skin, Primary cutaneous γδ T-cell lymphoma, CD30-positive T cell lymphoproliferative disorder, Lymphomatoid papulosis type D, Hydroa vacciniforme-like lymphoproliferative disorder, Extranodal NK/T-cell lymphoma, Subcutaneous panniculitis-like T-cell lymphoma, Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma